According to the American Chiropractic Association, chiropractic is a health care profession that focuses on disorders or the musculoskeletal system and the nervous system.
Typically, a chiropractor uses techniques to treat Nero musculoskeletal issues such as back and neck pain, pain in the joints, and headaches.
If you've have pain in your joints, neck, or back, or have debilitating headaches you might want to consider seeing a chiropractor.
What are the positive effects of chiropractic treatment and what can you expect from it?
Listen in as Craig Gelfound, DC, a chiropractor and member of the Medical Staff at Palmdale Regional Medical Center shares the effects chiropractic treatment can have on your body, and what you can expect from seeking chiropractic treatment.
Selected Podcast
When Should You Consider Chiropractic Treatment?
Featured Speaker:
Craig Gelfound, DC
Craig Gelfound, DC is a Chiropractor and a member of the Medical Staff at Palmdale Regional Medical Center. Transcription:
When Should You Consider Chiropractic Treatment?
Melanie Cole (Host): If you have pain in your joints, neck, or back, or have debilitating headaches, you might want to consider seeing a Chiropractor. My guest today is Dr. Craig Gelfound. He’s a Chiropractor and a member of the medical staff at Palmdale Regional Medical Center. Welcome to the show, Craig Gelfound, DC Tell us about what Chiropractors do today and how has this evolved?
Craig Gelfound, DC (Guest): Well, thank you, Melanie, for having me today. I think it is so great to be a Chiropractor today and I want to congratulate the Palmdale Regional Medical Center in being forward-thinking in allowing Chiropractors to be on the medical staff. There has been a major shift in what we do today as far as integrating healthcare, and Palmdale Regional Medical Center is definitely doing that. We have developed close to completion of an Oasis Center there, and that is going to be an Integrative Medical Center. Around the country medical schools and hospitals are teaming up and putting together these functional medicine programs -- Chiropractors, Exercise Physiologists, Cardiologists, all sorts of different disciplines are coming together to really help treat the patient. and what their ailments are. One of the things that Chiropractics has done in probably the last 20 years since I’ve graduated is really put a lot of time and effort into developing a body of research that has really helped support the things that we do. One of the things I like to do when I teach other Chiropractors about healthcare and what we do in forensics and how we prepare our patients is I like to always talk about the nervous system. We are neuromusculoskeletal specialists. We like to look at the body as a whole organism, and we like to look at the nervous system, the muscle system, and the skeletal system. I think this sets us apart from some of the other disciplines and one of the things that definitely sets us apart is out treatment method, and that is the adjustment to the body. Aside from that, we also counsel our patients in diet, in exercise, and other healthy lifestyle changes, so Chiropractics as a profession have been doing this for well over a hundred years. It’s great to see the medical profession and some of the other healthcare disciplines to come in and help now support this goal, which is now a new goal of the United States and healthcare, so I think that’s what we’ve been doing Melanie.
Melanie: What a wonderful definition and explanation that is, Dr. Gelfound. So, what does a Chiropractor – when you talk about neuromusculoskeletal injuries, or pain, or just issues that people have – what do you do? You mentioned the word manipulation, and that seems to have people raise their eyebrows. Explain what that is and how it works?
Craig Gelfound, DC: Well, the greatest way to explain what we term the adjustment to the body is the power of touch. If you just break down the word Chiropractic, it means, “to be done by hand,” so one of the unique things about the profession is we do everything by hand. We don’t use medicines, and we don’t do surgery, and we don’t use any needles or injections. That’s something that’s saved for the medical profession, or the Osteopathic profession.
When we touch a person, there are all kinds of sensory nerves that start to become stimulated and these sensory organs are in all kinds of tissue from the skin all the way down. We have specialized receptors that are in the muscle tendons within the muscle itself -- they measure length and tension. We have other sensors inside our ligaments that also measure the length and the stretch. We have joint mechanoreceptors that measure the joint motion from beginning to end and in the middle. All of these are stimulated just by touch or by motion, so when we set our hands on a patient and we start to manipulate or adjust and we stretch, or we move, and we put tension or pressure, all of these different sensory stimulations go to the brain.
The great thing about that is that that inhibits pain. As soon as you touch and rub, that starts to inhibit pain impulses. Let’s just say you sprained a joint or tissue in the body and you might have paid attention when your mother told you, “Rub it, rub it,” [LAUGHS] and basically, that rubbing motion starts to stimulate those sensory nerves. Those sensory nerves go into the spinal cord, they inhibit those sensory pain impulses because the pain impulses from an injured tissue go through very tiny, tiny wires that are not insulated, whereas the wires coming from the skin or some of the other tissues in the ligaments, in the tendons, in the muscles, those wires are thicker wires, and they’re insulated, so the signals travel faster. They inhibit those tiny wires from the pain impulses, and by the time it gets to the brain, the brain now, is having a different perception of what that pain or what that sensation was. What we do with our adjustments is we manipulate, or adjust the joint. That stimulates all of these different sensory organs. That inhibits the pain – and that’s the simplest way just to explain the Chiropractic adjustment.
Then, after we make these adjustments and we have a correction, now we give the patient some kind of exercise to adjust flexibility or strength or balance, and that’s where the real performance comes in. There are three things a person’s going to want to know. They're going to want to know, what's my diagnosis, how long is it going to take, and what can I do for myself? We have to get patients involved in their treatment, especially when it involves the musculoskeletal system because these symptoms need to be stimulated ongoing. If you just go to your doctor and he just gives you one treatment and then you don’t see him again for another week or two, then there’s no other treatment. We’ve got to get patients moving so that they can do multiple doses of treatment in every day.
Patients who come to see me they get exercises on every visit, and we build on that exercise. I give maybe one or two exercises the first time, and the next time they get another, one and another one thereafter. That way we’re building on a program, the patients are getting active, they’re seeing their progress, and they’re feeling better. That’s one of the ways we really like to help people, Melanie.
Melanie: So why the sound? People hear that they’re going to hear a popping sound when you make an adjustment, and certainly, the ones on the neck are sometimes – what could make somebody say, “Oh, what was that?” Do you think – when you’re answering this question, Dr. Gelfound, that that line – and you mentioned that many different disciplines are now coming together and doing some of the same things with exercise and strengthening, and that sort of thing. Do you think that that stigma against Chiropractors is fading away now?
Craig Gelfound, DC: I do believe that our image is much better than it ever was before. I think Medical Doctors, and Osteopaths, and Physical Therapists have now – pretty much understand that manual therapy, including Chiropractics is definitely beneficial to the neuromusculoskeletal system. When you think about the dollars that we spend in healthcare, let’s just say low back pain in general – between the age of 25 and 45 is the number one cause of disability, so when you look at those number, it’s staggering how many millions of dollars you spend on just low back pain alone. It can be a health care concern and a very important issue to take care of.
As far as what we do and how we go in about treating and adjusting it and having a patient feel that pop, the pop is definitely a measure of success to a degree. Again, because when we push on these joints, we’re moving them, and when we start to separate them in a way it decreases pressure inside the joint and when we make the final, quick adjustment through the elastic barrier, there is a sound called cavitation, which is the pop. That pop tells us that we made it through the elastic barrier, that we got the joint moving freely from beginning to end, and the stimulation of all those mechanoreceptors has taken place, and the brain is now perceiving more range of motion. That perception reduces pain, it reduces muscle spasm or muscle rigidity, and it gets more motion annnd that stimulates the fluid inside the joint to move better, and the patient feels better because there’s a reflex reduction in pain. That’s the simplest way to explain it. The pop is really just a mechanical pop of gasses that are dissolved inside the liquids, which is maintained inside our free-moving joints like our elbows, and our knees, and our shoulders, and those joints are the same in the spine.
Now, if a patient is a little bit apprehensive about feeling a pop, or they don’t like that noise, there are so many different techniques in Chiropractics. One of the things I definitely hear sometimes from other practitioners is don’t let the Chiropractor adjust your neck, or don’t go get Chiropractic care, but that is such a difficult thing to overcome sometimes because there’s so many things that we can do as Chiropractors. We don’t always have to produce that high-velocity thrust which gives the pop. We have other techniques, which are non-force techniques. We can use instrument-related techniques, and when we do that we’re still stimulating the neuromechanoreceptors to increase the sensory input, but we’re not necessarily being as invasive to the joint or the tissue. There are some times where it’s contraindicated to do that kind of manipulation or adjustment to a patient, so we have to have other things and other treatments that we can provide.
I will tell you, especially here in California, that by law that our Chiropractic act of 1922, which is what governs us, is that adjustments or manipulations are required to be part of our treatment plan, so even though it is a requirement for the treatment plan, it doesn’t have to be the high-velocity that gives the pop, we have so many other treatments that we can do. For anyone who’s listening and anyone who’s been apprehensive about seeing the Chiropractor, the thing you should absolutely not be afraid of is speaking up, telling your Chiropractor, “I’m a little bit concerned about having my joints popped. Is there a different technique maybe you could apply?” That Chiropractor should absolutely adjust his techniques to the patient, and that’s one of the ways we can overcome that objection, Melanie.
Melanie: In just the last few minutes, Dr. Gelfound, what would you like to tell people who are considering seeing a Chiropractor, maybe for the first time, what questions would you like them to ask? What would you like them to know about your field?
Craig Gelfound, DC: Well, one of the things you really have to know is that when a person wants to go see a healthcare provider, there are usually only three types of providers that can access a patient into the healthcare system, and that’s your Medical Doctor, your Doctors of Osteopathy, and a Chiropractor. Now, there are some ways sometimes a person can access a Nurse Practitioner solely, or maybe even a Physical Therapist, but those are extremely limited situations, but when they go to see someone off the street – let’s say they have pain, and that’s usually what brings somebody into our office is they usually have some pain, they come in.
Everyone, every patient, no matter who they see should expect a history of their condition – sometimes it needs to be a little bit more comprehensive based on the condition or the age, or the prior injuries or accidents, or medical conditions, so be prepared to give a history. And then a physical exam. Sometimes the physical exams are fairly focused. It could be a simple thing, like maybe it’s just a wrist or an elbow – that’s a simple, focused exam that doesn’t require a lot of extra testing, but it can be more complex. Sometimes the patient’s history, or family history, or prior injuries make it required for the doctor to do a more comprehensive examination where they have to go into the neurology, or to the muscle testing and the range of motion with Orthopedic maneuvers, and other things. Maybe we even need some special imaging. Sometimes an X-Ray is required, maybe even an MRI or a CT scan and Chiropractors can definitely order all this type of special testing. They can even order laboratory tests, which I do on an infrequent basis with some of my patients to go over those situations. Then, you should expect to get a diagnosis, and then a treatment plan, and then some response with a reexamination at some later date to see what the response of care has been.
If all of these steps are fairly carried out in a normal way, patients should expect to see a Chiropractor six to twelve visits and then be re-evaluated. Usually, that’s a fairly standard way to go about receiving care for almost any manual therapy-type situation. I think that’s pretty much across the board on a standardized – what’s normal in the industry.
Now, there may be some situations where people are seeing Chiropractors for a lot longer than that. There may be some extenuating circumstances or some other conditions, and some people even see less. I see some patients one or two visits; they’re fine, they get their exercises, they move on. They are fairly healthy individuals. And then I have other patients who I’ve seen regularly for years, and then I see their children, and now I’m even seeing some grandchildren come into the picture. It’s been a joy being a Chiropractor over the last 20 years.
Melanie: And why should they come to Palmdale Regional Medical Center for their care?
Craig Gelfound, DC: Well, again, Palmdale Regional Medical Center, located in Palmdale California, has really been innovative in trying to get a multidisciplinary type of situation going. This, I believe, is only the second year that I’m on the medical staff there. I think it will be two years in June. We’re putting together – I think we have three Chiropractors on staff right now and the majority of the situations that we might be called in is maybe on a consultation to help another doctor do something. Currently, right now, we don’t admit patients on our own, so we wouldn’t be doing that, but Chiropractic at the Palmdale Regional Medical Center will most likely be a complementary alternative practice where we’re in there and this Oasis Center, once it’s completely created, will be a much better facility to help patients deal with all kinds of neuromusculoskeletal ailments and it’s just going to be a wonderful place. I can’t wait until it’s completed and the community here is just going to love it.
Melanie: Thank you, so much, for being with us today. That’s really great information. You’re listening to Palmdale Regional Radio with Palmdale Regional Medical Center. For more information, you can go to PalmdaleRegional.com, that’s PalmdaleRegional.com. Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks, so much, for listening.
When Should You Consider Chiropractic Treatment?
Melanie Cole (Host): If you have pain in your joints, neck, or back, or have debilitating headaches, you might want to consider seeing a Chiropractor. My guest today is Dr. Craig Gelfound. He’s a Chiropractor and a member of the medical staff at Palmdale Regional Medical Center. Welcome to the show, Craig Gelfound, DC Tell us about what Chiropractors do today and how has this evolved?
Craig Gelfound, DC (Guest): Well, thank you, Melanie, for having me today. I think it is so great to be a Chiropractor today and I want to congratulate the Palmdale Regional Medical Center in being forward-thinking in allowing Chiropractors to be on the medical staff. There has been a major shift in what we do today as far as integrating healthcare, and Palmdale Regional Medical Center is definitely doing that. We have developed close to completion of an Oasis Center there, and that is going to be an Integrative Medical Center. Around the country medical schools and hospitals are teaming up and putting together these functional medicine programs -- Chiropractors, Exercise Physiologists, Cardiologists, all sorts of different disciplines are coming together to really help treat the patient. and what their ailments are. One of the things that Chiropractics has done in probably the last 20 years since I’ve graduated is really put a lot of time and effort into developing a body of research that has really helped support the things that we do. One of the things I like to do when I teach other Chiropractors about healthcare and what we do in forensics and how we prepare our patients is I like to always talk about the nervous system. We are neuromusculoskeletal specialists. We like to look at the body as a whole organism, and we like to look at the nervous system, the muscle system, and the skeletal system. I think this sets us apart from some of the other disciplines and one of the things that definitely sets us apart is out treatment method, and that is the adjustment to the body. Aside from that, we also counsel our patients in diet, in exercise, and other healthy lifestyle changes, so Chiropractics as a profession have been doing this for well over a hundred years. It’s great to see the medical profession and some of the other healthcare disciplines to come in and help now support this goal, which is now a new goal of the United States and healthcare, so I think that’s what we’ve been doing Melanie.
Melanie: What a wonderful definition and explanation that is, Dr. Gelfound. So, what does a Chiropractor – when you talk about neuromusculoskeletal injuries, or pain, or just issues that people have – what do you do? You mentioned the word manipulation, and that seems to have people raise their eyebrows. Explain what that is and how it works?
Craig Gelfound, DC: Well, the greatest way to explain what we term the adjustment to the body is the power of touch. If you just break down the word Chiropractic, it means, “to be done by hand,” so one of the unique things about the profession is we do everything by hand. We don’t use medicines, and we don’t do surgery, and we don’t use any needles or injections. That’s something that’s saved for the medical profession, or the Osteopathic profession.
When we touch a person, there are all kinds of sensory nerves that start to become stimulated and these sensory organs are in all kinds of tissue from the skin all the way down. We have specialized receptors that are in the muscle tendons within the muscle itself -- they measure length and tension. We have other sensors inside our ligaments that also measure the length and the stretch. We have joint mechanoreceptors that measure the joint motion from beginning to end and in the middle. All of these are stimulated just by touch or by motion, so when we set our hands on a patient and we start to manipulate or adjust and we stretch, or we move, and we put tension or pressure, all of these different sensory stimulations go to the brain.
The great thing about that is that that inhibits pain. As soon as you touch and rub, that starts to inhibit pain impulses. Let’s just say you sprained a joint or tissue in the body and you might have paid attention when your mother told you, “Rub it, rub it,” [LAUGHS] and basically, that rubbing motion starts to stimulate those sensory nerves. Those sensory nerves go into the spinal cord, they inhibit those sensory pain impulses because the pain impulses from an injured tissue go through very tiny, tiny wires that are not insulated, whereas the wires coming from the skin or some of the other tissues in the ligaments, in the tendons, in the muscles, those wires are thicker wires, and they’re insulated, so the signals travel faster. They inhibit those tiny wires from the pain impulses, and by the time it gets to the brain, the brain now, is having a different perception of what that pain or what that sensation was. What we do with our adjustments is we manipulate, or adjust the joint. That stimulates all of these different sensory organs. That inhibits the pain – and that’s the simplest way just to explain the Chiropractic adjustment.
Then, after we make these adjustments and we have a correction, now we give the patient some kind of exercise to adjust flexibility or strength or balance, and that’s where the real performance comes in. There are three things a person’s going to want to know. They're going to want to know, what's my diagnosis, how long is it going to take, and what can I do for myself? We have to get patients involved in their treatment, especially when it involves the musculoskeletal system because these symptoms need to be stimulated ongoing. If you just go to your doctor and he just gives you one treatment and then you don’t see him again for another week or two, then there’s no other treatment. We’ve got to get patients moving so that they can do multiple doses of treatment in every day.
Patients who come to see me they get exercises on every visit, and we build on that exercise. I give maybe one or two exercises the first time, and the next time they get another, one and another one thereafter. That way we’re building on a program, the patients are getting active, they’re seeing their progress, and they’re feeling better. That’s one of the ways we really like to help people, Melanie.
Melanie: So why the sound? People hear that they’re going to hear a popping sound when you make an adjustment, and certainly, the ones on the neck are sometimes – what could make somebody say, “Oh, what was that?” Do you think – when you’re answering this question, Dr. Gelfound, that that line – and you mentioned that many different disciplines are now coming together and doing some of the same things with exercise and strengthening, and that sort of thing. Do you think that that stigma against Chiropractors is fading away now?
Craig Gelfound, DC: I do believe that our image is much better than it ever was before. I think Medical Doctors, and Osteopaths, and Physical Therapists have now – pretty much understand that manual therapy, including Chiropractics is definitely beneficial to the neuromusculoskeletal system. When you think about the dollars that we spend in healthcare, let’s just say low back pain in general – between the age of 25 and 45 is the number one cause of disability, so when you look at those number, it’s staggering how many millions of dollars you spend on just low back pain alone. It can be a health care concern and a very important issue to take care of.
As far as what we do and how we go in about treating and adjusting it and having a patient feel that pop, the pop is definitely a measure of success to a degree. Again, because when we push on these joints, we’re moving them, and when we start to separate them in a way it decreases pressure inside the joint and when we make the final, quick adjustment through the elastic barrier, there is a sound called cavitation, which is the pop. That pop tells us that we made it through the elastic barrier, that we got the joint moving freely from beginning to end, and the stimulation of all those mechanoreceptors has taken place, and the brain is now perceiving more range of motion. That perception reduces pain, it reduces muscle spasm or muscle rigidity, and it gets more motion annnd that stimulates the fluid inside the joint to move better, and the patient feels better because there’s a reflex reduction in pain. That’s the simplest way to explain it. The pop is really just a mechanical pop of gasses that are dissolved inside the liquids, which is maintained inside our free-moving joints like our elbows, and our knees, and our shoulders, and those joints are the same in the spine.
Now, if a patient is a little bit apprehensive about feeling a pop, or they don’t like that noise, there are so many different techniques in Chiropractics. One of the things I definitely hear sometimes from other practitioners is don’t let the Chiropractor adjust your neck, or don’t go get Chiropractic care, but that is such a difficult thing to overcome sometimes because there’s so many things that we can do as Chiropractors. We don’t always have to produce that high-velocity thrust which gives the pop. We have other techniques, which are non-force techniques. We can use instrument-related techniques, and when we do that we’re still stimulating the neuromechanoreceptors to increase the sensory input, but we’re not necessarily being as invasive to the joint or the tissue. There are some times where it’s contraindicated to do that kind of manipulation or adjustment to a patient, so we have to have other things and other treatments that we can provide.
I will tell you, especially here in California, that by law that our Chiropractic act of 1922, which is what governs us, is that adjustments or manipulations are required to be part of our treatment plan, so even though it is a requirement for the treatment plan, it doesn’t have to be the high-velocity that gives the pop, we have so many other treatments that we can do. For anyone who’s listening and anyone who’s been apprehensive about seeing the Chiropractor, the thing you should absolutely not be afraid of is speaking up, telling your Chiropractor, “I’m a little bit concerned about having my joints popped. Is there a different technique maybe you could apply?” That Chiropractor should absolutely adjust his techniques to the patient, and that’s one of the ways we can overcome that objection, Melanie.
Melanie: In just the last few minutes, Dr. Gelfound, what would you like to tell people who are considering seeing a Chiropractor, maybe for the first time, what questions would you like them to ask? What would you like them to know about your field?
Craig Gelfound, DC: Well, one of the things you really have to know is that when a person wants to go see a healthcare provider, there are usually only three types of providers that can access a patient into the healthcare system, and that’s your Medical Doctor, your Doctors of Osteopathy, and a Chiropractor. Now, there are some ways sometimes a person can access a Nurse Practitioner solely, or maybe even a Physical Therapist, but those are extremely limited situations, but when they go to see someone off the street – let’s say they have pain, and that’s usually what brings somebody into our office is they usually have some pain, they come in.
Everyone, every patient, no matter who they see should expect a history of their condition – sometimes it needs to be a little bit more comprehensive based on the condition or the age, or the prior injuries or accidents, or medical conditions, so be prepared to give a history. And then a physical exam. Sometimes the physical exams are fairly focused. It could be a simple thing, like maybe it’s just a wrist or an elbow – that’s a simple, focused exam that doesn’t require a lot of extra testing, but it can be more complex. Sometimes the patient’s history, or family history, or prior injuries make it required for the doctor to do a more comprehensive examination where they have to go into the neurology, or to the muscle testing and the range of motion with Orthopedic maneuvers, and other things. Maybe we even need some special imaging. Sometimes an X-Ray is required, maybe even an MRI or a CT scan and Chiropractors can definitely order all this type of special testing. They can even order laboratory tests, which I do on an infrequent basis with some of my patients to go over those situations. Then, you should expect to get a diagnosis, and then a treatment plan, and then some response with a reexamination at some later date to see what the response of care has been.
If all of these steps are fairly carried out in a normal way, patients should expect to see a Chiropractor six to twelve visits and then be re-evaluated. Usually, that’s a fairly standard way to go about receiving care for almost any manual therapy-type situation. I think that’s pretty much across the board on a standardized – what’s normal in the industry.
Now, there may be some situations where people are seeing Chiropractors for a lot longer than that. There may be some extenuating circumstances or some other conditions, and some people even see less. I see some patients one or two visits; they’re fine, they get their exercises, they move on. They are fairly healthy individuals. And then I have other patients who I’ve seen regularly for years, and then I see their children, and now I’m even seeing some grandchildren come into the picture. It’s been a joy being a Chiropractor over the last 20 years.
Melanie: And why should they come to Palmdale Regional Medical Center for their care?
Craig Gelfound, DC: Well, again, Palmdale Regional Medical Center, located in Palmdale California, has really been innovative in trying to get a multidisciplinary type of situation going. This, I believe, is only the second year that I’m on the medical staff there. I think it will be two years in June. We’re putting together – I think we have three Chiropractors on staff right now and the majority of the situations that we might be called in is maybe on a consultation to help another doctor do something. Currently, right now, we don’t admit patients on our own, so we wouldn’t be doing that, but Chiropractic at the Palmdale Regional Medical Center will most likely be a complementary alternative practice where we’re in there and this Oasis Center, once it’s completely created, will be a much better facility to help patients deal with all kinds of neuromusculoskeletal ailments and it’s just going to be a wonderful place. I can’t wait until it’s completed and the community here is just going to love it.
Melanie: Thank you, so much, for being with us today. That’s really great information. You’re listening to Palmdale Regional Radio with Palmdale Regional Medical Center. For more information, you can go to PalmdaleRegional.com, that’s PalmdaleRegional.com. Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks, so much, for listening.